Mental Fatigue Impairs Endurance Performance: A Physiological Explanation

Does music counteract mental fatigue? A systematic review

INTRODUCTION

Mental fatigue, a psychobiological state induced by prolonged and sustained cognitive tasks, impairs both cognitive and physical performance. Several studies have investigated strategies to counteract mental fatigue. However, potential health risks and contextual restrictions often limit these strategies, which hinder their practical application. Due to its noninvasive and portable nature, music has been proposed as a promising strategy to counteract mental fatigue. However, the effects of music on performance decrements vary with different music styles. Synthesizing studies that systematically report music style and its impact on counteracting performance decrements is crucial for theoretical and practical applications.

OBJECTIVES

This review aims to provide a comprehensive systematic analysis of different music styles in counteracting mental fatigue and their effects on performance decrements induced by mental fatigue. Additionally, the mechanisms by which music counteracts mental fatigue will be discussed.

METHODS

A comprehensive search was conducted across five databases-Web of Science, PubMed, SCOPUS, SPORTDiscus via EBSCOhost, and the Psychological and Behavioral Sciences Collection via EBSCOhost-up to November 18, 2023. The selected studies focused solely on music interventions, with outcomes including subjective feelings of mental fatigue, physiological markers, and both cognitive and behavioral performance.

RESULTS

Nine studies met the predetermined criteria for inclusion in this review. The types of music interventions that counteract mental fatigue include relaxing, exciting, and personal preference music, all of which were associated with decreased subjective feelings of mental fatigue and changes in objective physiological markers. Cognitive performance, particularly in inhibition and working memory tasks impaired by mental fatigue, was countered by both relaxing and exciting music. Exciting music was found to decrease reaction time more effectively than relaxing music in working memory tasks. The physiological marker of steady-state visually evoked potential-based brain-computer interface (SSVEP-BCI) amplitude increased, confirming that exciting music counteracts mental fatigue more effectively than relaxing music. Behavioral performance in tasks such as arm-pointing, the Yo-Yo intermittent test, and the 5 km time-trial, which were impaired by mental fatigue, were counteracted by personal preference music.

CONCLUSION

Relaxing music, exciting music, and personal preference music effectively counteract mental fatigue by reducing feelings of fatigue and mitigating performance decrements. Individuals engaged in mentally demanding tasks can effectively counteract concurrent or subsequent cognitive performance decrements by simultaneously listening to relaxing or exciting music without lyrics or by using music during recovery from mental fatigue. Exciting music is more effective than relaxing music in counteracting mental fatigue. Personal preference music is effective in counteracting behavioral performance decrements in motor control and endurance tasks. Mentally fatigued individuals could apply personal preference music to counteract subsequent motor control performance decrements or simultaneously listen to it to counteract endurance performance decrements. Future studies should specify and examine the effects of different music genres, tempos, and intensities in counteracting mental fatigue. Additionally, the role of music in counteracting mental fatigue in contexts such as work productivity, traffic accident risk, and sports requires further investigation, along with the underlying mechanisms.

Do prolonged social media use or cognitive tasks impair neuroelectric and visuomotor performance in taekwondo athletes? A randomized and controlled trial

OBJECTIVES

We aimed to compare whether: (1) social media use (SMU) would induce a similar state of mental fatigue compared to the Modified Stroop task (MST); (2) the SMU and the MST would affect neuroelectric responses; and (3) sport-specific visuomotor performance in the taekwondo (TKD) athletes was impaired by mental fatigue.

METHODS

Fifteen TKD athletes underwent a 60-min Modified Stroop Task (MST), engaged in SMU, or watched a documentary (CON) in a randomized order. Pre and post-each conditions they responded to a Stroop task (ST) while the event-related potentials (ERP) were measured. The Visual Analogue Scale for mental tiredness (VAS-MT) was used to measure subjective feelings of mental fatigue Then, the athletes completed TKD-specific visuomotor tests.

RESULTS

The VAS-MT response increases progressively in the MST condition (p < 0.001). The response time of ST was slower in the MST than in SMU (p = 0.04). The accuracy dropped in MST comparing pre- and post-manipulation (p < 0.001) and was lower than post-CON (p = 0.005). The peak amplitude for N200 ERP was higher post-than pre for all conditions (p < 0.001) on the Fz channel. N200 amplitude was higher on CON than MST on post-manipulation (p = 0.02). The amplitude increased significantly from pre-to post in the CON condition (p = 0.009) on the Cz channel. There was no difference in visuomotor performance among conditions (all ps > 0.05).

CONCLUSION

Prolonged performance of the MST, but not SMU, induces a state of mental fatigue. Neuroelectric and cognitive responses were impaired by mental fatigue induced by MST, but the visuomotor performance remained unaffected by any condition.

Adding a sustained attention task to a physically demanding cycling exercise exacerbates neuromuscular fatigue and impairs cognitive performance in both normoxia and hypoxia

PURPOSE

Both cognitive motor dual-tasks (CMDT) protocols and hypoxic environments have been associated with significant impairments in cognitive and physical performance. We aimed to determine the effects of hypoxia on cognitive performance and neuromuscular fatigue during a highly physically demanding CMDT.

METHODS

Fifteen young adults completed a first session involving a cognitive task (CTLCOG) followed by cycling exercise (CTLEX) in normoxia. After that, they randomly participated in CMDT sessions in normoxia (DTNOR) and hypoxia (DTHYP). The physical exercise consisted of 20 min cycling at a "hard" perceived effort, and the cognitive task consisted of 15 min sustained attention to response time task (SART). Concurrent psycho-physiological measurements included: quadriceps neuromuscular fatigue (peripheral/central components from femoral nerve electrostimulation), prefrontal cortex (PFC) oxygenation by near-infrared spectroscopy, and perception of effort.

RESULTS

SART performance significantly decreased in DTNOR (-15.7 ± 15.6%, P < 0.01) and DTHYP (-26.2 ± 16.0%, P < 0.01) compared to CTLCOG (-1.0 ± 17.7%, P = 0.61). Peripheral fatigue similarly increased across conditions, whereas the ability of the central nervous system to activate the working muscles was impaired similarly in DTNOR (-6.1 ± 5.9%, P < 0.001) and DTHYP (-5.4 ± 7.3%, P < 0.001) compared to CTLEX (-1.1 ± 0.2%, P = 0.52). Exercise-induced perception of effort was higher in DTHYP vs. DTNOR and in DTNOR vs. CTLEX. This was correlated with cognitive impairments in both normoxia and hypoxia. PFC deoxygenation was more pronounced in DTHYP compared to DTNOR and CTLEX.

CONCLUSION

In conclusion, performing a sustained attention task together with physically challenging cycling exercise promotes central neuromuscular fatigue and impairs cognitive accuracy; the latter is particularly noticeable when the CMDT is performed in hypoxia.

Mental Fatigue and Sports Performance of Athletes: Theoretical Explanation, Influencing Factors, and Intervention Methods

Mental fatigue is an important factor affecting athletes' performance. Explaining the effects of mental fatigue on sports performance from a theoretical point of view can help us deeply understand the interconnection between mental fatigue and sports performance and conduct effective interventions based on this. Combining the relevant literature in China and abroad reveals that the current academic theories on the mechanism of sports fatigue include motivational control theory, underload theory, neural waste disposal hypothesis, and resource depletion theory. The effects of mental fatigue on performance are reflected in aerobic endurance, sports decision-making, tactical performance, and technical performance. Current coping strategies for mental fatigue include physiological coping strategies based on nutrition (caffeine), odor, and noninvasive neuromodulation techniques and psychological and behavioral coping strategies based on music and positive thinking.

The Effects of Mental Fatigue Induced by the Stroop Test on Muscular Endurance Performance and Neuromuscular Activation in Division III Female Athletes

The purpose of this study was to investigate the effect that mental fatigue, as induced by a Stroop test, has on resistance training performance outcomes such as muscular endurance, power output, and neuromuscular activation. Seven female college-aged NCAA Division III student-athletes with at least one year of resistance training experience and were within the 50th percentile for maximal aerobic capacity provided informed consent for participation. During two separate visits, using a within-subject crossover experimental design, subjects completed either the experimental or control condition. Subjects then completed a to-failure leg press test at 50% of their 1-repetition maximum (1RM) followed by an isometric midthigh pull (IMTP) attempt with electromyography (EMG) analysis. The experimental condition consisted of a 30-minute Stroop test, while the control condition consisted of watching 30 minutes of a sitcom. Both activities were completed while cycling at 40% of their aerobic capacity. A NASA Task Load Index (TLX) inventory was administered following the completion of each cycling session to determine the perceived workload and mental fatigue of each activity. While the mentally fatiguing condition was significantly more mentally fatiguing (p = 0.02) than the control condition, mental fatigue did not statistically affect any of the evaluated performance outcomes (p>0.05). These findings suggest that mental fatigue, a common symptom of psychological stress, does not affect resistance-training-related performance outcomes among female athletic populations.

Intelligent Human Operator Mental Fatigue Assessment Method Based on Gaze Movement Monitoring

Modern mental fatigue detection methods include many parameters for evaluation. For example, many researchers use human subjective evaluation or driving parameters to assess this human condition. Development of a method for detecting the functional state of mental fatigue is an extremely important task. Despite the fact that human operator support systems are becoming more and more widespread, at the moment there is no open-source solution that can monitor this human state based on eye movement monitoring in real time and with high accuracy. Such a method allows the prevention of a large number of potential hazardous situations and accidents in critical industries (nuclear stations, transport systems, and air traffic control). This paper describes the developed method for mental fatigue detection based on human eye movements. We based our research on a developed earlier dataset that included captured eye-tracking data of human operators that implemented different tasks during the day. In the scope of the developed method, we propose a technique for the determination of the most relevant gaze characteristics for mental fatigue state detection. The developed method includes the following machine learning techniques for human state classification: random forest, decision tree, and multilayered perceptron. The experimental results showed that the most relevant characteristics are as follows: average velocity within the fixation area; average curvature of the gaze trajectory; minimum curvature of the gaze trajectory; minimum saccade length; percentage of fixations shorter than 150 ms; and proportion of time spent in fixations shorter than 150 milliseconds. The processing of eye movement data using the proposed method is performed in real time, with the maximum accuracy (0.85) and F1-score (0.80) reached using the random forest method.

The Influence of Mental Fatigue on Physical Performance and Its Relationship with Rating Perceived Effort and Enjoyment in Older Adults

The study investigated the influence of mental fatigue on older people's enjoyment during a series of physical exercises. Using a randomized cross-over design, participants (n = 35) completed a 6-minute walking test - 6MWT, a Timed Up and Go-TUG test and three sets of knee extension exercise (first set: KE1, second set: KE2, third set: KE3) under two experimental conditions (control or mental fatigue). The Nonparametric Analysis of Longitudinal Data in Factorial Experiments was used to compare the number of repetitions performed during three sets of resistance exercise between conditions. The same analysis method was applied to compare the perception of effort and enjoyment across five moments (Post-6MWT, Post-TUG, Post-KE1, Post-KE2, Post-KE3) and two conditions and the Visual Analogue Scales (VAS) across four moments (baseline, Pre-6MWT, Pre-TUG, Pre-KE) and two conditions. Mental fatigue did not affect the physical function, perception of effort and enjoyment of exercise in older people. Participants, however, reported higher enjoyment for walking and dynamic balance compared to strength exercise. Mental fatigue had no effect on the physical function, perception of effort and enjoyment of exercise of older people. Participants presented a higher enjoyment for walking and dynamic balance compared to strength exercise. Given the importance of resistance exercises for health, clinicians should prioritize resources to education programs emphasizing the benefits of resistance exercise in both short- and long-term health. Including social interaction opportunities in physical exercise programs and prescribing activities appropriate to participants' ability levels could enhance engagement and adherence.

Examining the Independent and Interactive Carryover Effects of Cognitive and Physical Exertions on Physical Performance

OBJECTIVE

This study compared the effects of prior cognitive, physical, and concurrent exertion on physical performance.

BACKGROUND

Fatiguing cognitive and physical exertions have been shown to negatively affect subsequent task performance. However, it is not clearly understood if concurrent physical and cognitive effort may exaggerate the negative carryover effects on physical task performance when compared to cognitive or physical exertion alone.

METHOD

Twenty-five participants completed four isometric handgrip endurance trials on different days. The endurance trials were preceded by four, 15-minute experimental manipulations (cognitive, physical, concurrent, control). Electromyography (EMG) and force tracing performance were monitored, with handgrip strength measured pre and post. Subjective ratings of mental and physical fatigue, as well as affect, motivation, and task self-efficacy, were also assessed.

RESULTS

Handgrip strength decreased following both physical (-14.4% MVC) and concurrent (-12.3% MVC) exertion manipulations, with no changes being observed for the cognitive and control conditions. No differences were observed across conditions for endurance time, EMG, nor tracing performance. When compared to the control conditions, perceptions of mental and physical fatigue were higher following the experimental manipulation. Endurance trial self-efficacy was lower for the mental, physical and concurrent conditions compared to control.

CONCLUSION

The concurrent condition resulted in similar decreases in strength as the physical fatigue condition, but otherwise resulted in similar carryover effects on endurance performance across all conditions. Further study is required at higher exposure levels, or for longer exposure durations, to further probe the influence of concurrent physical and cognitive effort on task performance.

APPLICATION

Concurrent cognitive and physical effort resulted in similar physical performance decrements to physical effort alone.

Comparison of mental fatigue using EEG signals and task performance in normal and slump posture adults during computer typing

OBJECTIVES

Slump sitting at workstations has been focused on by clinicians and researchers nowadays; however, there is limited evidence to date that improper positioning affects the mental state. Accordingly, the main objective of this research was to examine the impact of slump posture on mental fatigue and task performance.

METHODS

A sample of 60 participants, 30 in each group including those with normal and slump postures were recruited to perform an hour of typing on the computer. Mental fatigue through EEG and task performances were considered as outcome measures and then were analyzed statistically in the first and last 3 min of typing.

RESULTS

The EEG showed a significant increasing trend in theta rhythm at different brain regions during 60 min of typing (P < 0.05). Besides, an interaction between time and posture was observed; it can mean the increasing trend of theta rhythm is different in normal and slump posture acquired sets (P < 0.05). Interestingly the speed of typing was found to be better (P < 0.05) in the normal posture group while no difference found between the groups in terms of errors (P > 0.05).

CONCLUSION

Our results showed poor posture can induce more mental fatigue during the given task, than the normal posture. These findings have provided evidence to indicate that in addition to the peripheral and biomechanical component, the assessment of the cortex as the central component should be considered in poor posture individuals. Besides, for any possible physical therapy rehabilitation protocol for the management of poor posture, the peripheral and central components should be focused.

TRIAL REGISTRATION

Registered on the Iranian Registry of Clinical Trials on September 21, 2022, IRCT Identifier: IRCT20161026030516N2.

Case Report: Differences in self-selected pacing in 20, 40, and 60 ironman-distance triathlons: a case study

Background

Triathletes are pushing their limits in multi-stage Ironman-distance triathlons. In the present case study, we investigated the pacing during 20, 40, and 60 Ironman-distance triathlons in 20, 40, and 60 days, respectively, of one professional IRONMAN® triathlete.

Case study

Event 1 (20 Ironman-distance triathlons in 20 days), Event 2 (40 Ironman-distance triathlons in 40 days), and Event 3 (60 Ironman-distance triathlons in 60 days) were analyzed by discipline (swimming, cycling, running, and overall event time), by Deca intervals (10 days of consecutive Ironman-distance triathlons) and additional data (sleep duration, body mass, heart rate in cycling and running). To test differences between Events and Deca intervals within the same discipline, T-tests (2 groups) or one-way ANOVAs (3 or more groups) were used.

Results

Swimming splits were fastest in Event 1, (ii) cycling and running splits were fastest in both Event 2 and 3, (iii) overall speed was fastest in Event 3, (iv) sleep duration increased during Event 2 but decreased in Event 3, (v) body mass decreased in Event 2, but increased in Event 3 and (vi) heart rate during cycling was similar in both Event 2 and 3. In contrast, heart rate during running was greater in Event 3.

Conclusion

In a professional IRONMAN® triathlete finishing 20, 40, and 60 Ironman-distance triathlons in 20, 40, and 60 days, respectively, split performances and both anthropometrical and physiological changes such as body mass and heart rate differed depending upon the duration of the events.

The interplay of brain neurotransmission and mental fatigue: A research protocol

INTRODUCTION

Mental fatigue (MF) significantly affects both cognitive and physical performance. However, the precise mechanisms, particularly concerning neurotransmission, require further investigation. An implication of the role of dopamine (DA) and noradrenaline (NA) is stated, but empirical evidence for this theory still needs to be provided. To address this gap, we aim to investigate the role of brain neurotransmission in elucidating if, and how prolonged cognitive activity induces MF and its subsequent impact on cognitive performance.

METHODS

This study (registration number: G095422N) will adopt a randomized cross-over design with sixteen healthy participants aged 18-35 years. The sessions include a familiarization, two experimental (DA: 20mg Methylphenidate; NA: 8mg Reboxetine) conditions, and one placebo (lactose tablet: 10mg) condition. A 60-minute individualized Stroop task will be used to investigate whether, and how the onset of MF changes under the influence of reuptake inhibitors. Attention and response inhibition will be assessed before and after the MF-inducing task using a Go/NoGo task. The integration of physiological (electroencephalography, heart rate), behavioral (attention, response inhibition), and subjective indicators (scales and questionnaires) will be used to detect the underlying mechanisms holistically. Data analysis will involve linear mixed models with significance at p<0.05.

DISCUSSION

The integration of diverse techniques and analyses offers a comprehensive perspective on the onset and impact of MF, introducing a novel approach. Future research plans involve extending this protocol to explore the connection between brain neurotransmission and physical fatigue. This protocol will further advance our understanding of the complex interplay between the brain and fatigue.

Fatigued or bored? Investigating the effect of different types of mental fatigue on 3 km running performance

Mental fatigue has been highly cited as having a negative impact on endurance performance. Few, however, have investigated whether different types of mental fatigue, namely active and passive fatigue, might affect endurance performance differently. This study used a repeated-measures design where 11 participants completed a 3 km run after three 32-min conditions: an actively fatiguing task (Task-load Dual-back; TloadDback); a passively fatiguing task (Mackworth Clock); and a control task (Documentary). Subjective ratings and performance on a second task (Flanker task) were taken before and after the 32-min tasks, while ratings of perceived effort, motivation and workload were taken during the 3 km run. Results showed that both fatigue conditions were mentally fatiguing, with the TloadDback rated as more demanding and the Mackworth Clock more boring and less motivating. Performance on subsequent tasks showed different effects: the TloadDback condition had the slowest responses on the post-test Flanker task, while the Mackworth Clock condition had the slowest completion time on the 3 km run, though this difference in completion times was non-significant. These results suggest that different cognitive tasks lead to different types of mental fatigue, which can lead to different outcomes on subsequent cognitive tasks but non-significant differences on subsequent physical tasks. This study highlights that to understand the influence of mental fatigue on physical performance, it is important to understand the cognitive tasks used and how different cognitive and physical tasks interact. Future work should examine whether performance outcomes in other areas commonly affected by mental fatigue, like technical and tactical sporting skills, are affected differently by active and passive fatigue.

Examining the effects of caffeine during an auditory attention task

Participants completed two sessions of an auditory attention task and intermittently responded to thought probes asking about their level of mind-wandering. After the first session one group received 200 mg of caffeinated chewing gum (n = 61) and another group received regular (placebo) chewing gum (n = 66). The gum was chewed for 20-minutes and then disposed of before beginning the second session. Participants who received caffeine showed a performance benefit as well as reported being more on task and fewer instances of spontaneous mind-wandering compared to those in the placebo group. Participants who received caffeine also reported greater positive affect and arousal, as well as less feelings of boredom, sleepiness, and mental effort required to stay on task compared to those who received placebo. These results suggest that caffeine may benefit attentional engagement as well as performance during a sustained attention task.

Does mental fatigue affect performance in racket sports? A systematic review

Mental fatigue impairs performance across several sports domains. However, a systematic review on its effects on racket sports performance has been lacking due to the previous scarcity of studies. This review aims to provide a comprehensive review the effects of mental fatigue on racket players' performance, with a discussion of the underlying mechanisms. A thorough search was conducted across five databases, including Web of Science, PubMed, SCOPUS, SPORTDiscus (via EBSCOhost), and the Psychological and Behavioral Science Collection (via EBSCOhost). The PICOS framework established the inclusion criteria: (1) healthy racket sports players; (2) induction of mental fatigue in both field and laboratory settings; (3) comparison of mental fatigue interventions with a control group (e.g., watching a movie or reading a magazine); (4) assessment of performance outcomes, including physical performance, skilled performance, and perceptual-cognitive performance; and (5) randomized controlled trials (RCTs), non-randomized controlled trials (non-RCTs), and non-randomized non-controlled trials. Mental fatigue manipulation, subjective evaluation, and (neuro)physiological markers were synthesized to support the successful induction of mental fatigue. Performance was categorized into tennis, table tennis, badminton, and padel based on the characteristics of specific racket sports domains. Secondary outcomes, such as the rate perception of effort (RPE) and motivation, were synthesized to explain the mechanisms based on the prominent theory of the Psychobiological model of endurance performance. Six studies revealed that mental fatigue impacts stroke performance in table tennis, affecting speed, accuracy, faults, and only second-serve accuracy in tennis. The response time of psychomotor performance increased in table tennis, padel, and badminton. Meanwhile, mental fatigue increased the RPE and remained unchanged in heart rate, blood glucose, and lactate, consistent with the Psychobiological model of endurance performance. Additionally, attention is suggested as a significant underlying psychobiological factor.

Association of Physical and Emotional Parameters with Performance of Firefighters: A Systematic Review

Firefighting requires a high level of physical fitness and causes substantial psychological stress, engendering musculoskeletal, mental, and cardiac issues. Consequently, it is necessary to measure the preparation of the firefighters daily through the Firefighting Physical Ability Tests (FPATs). According to the literature, some variables are more important for performance in the FPAT. Therefore, we aimed to summarize evidence that relates physical and mental aspects to the FPAT performance. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method, screening 1055 records from databases and selecting 15 that met inclusion criteria. No emotional and psychological variables were correlated with the FPAT. Most research shows significant correlations between the FPAT performance and the following: aerobic fitness, upper body endurance and strength, anaerobic capacity, body fat, and age. Lower body endurance and strength, as well as anaerobic power, had a low number of investigations and need to be further explored. Abdominal endurance showed weak correlations, while flexibility did not show any correlations in most studies, although these should be considered for injury prevention. We recommend that fitness programs and evaluations include a global analysis considering the evidence presented for methodological improvements.

Research on mental fatigue during long-term motor imagery: a pilot study

Mental fatigue during long-term motor imagery (MI) may affect intention recognition in MI applications. However, the current research lacks the monitoring of mental fatigue during MI and the definition of robust biomarkers. The present study aims to reveal the effects of mental fatigue on motor imagery recognition at the brain region level and explore biomarkers of mental fatigue. To achieve this, we recruited 10 healthy participants and asked them to complete a long-term motor imagery task involving both right- and left-handed movements. During the experiment, we recorded 32-channel EEG data and carried out a fatigue questionnaire for each participant. As a result, we found that mental fatigue significantly decreased the subjects' motor imagery recognition rate during MI. Additionally the theta power of frontal, central, parietal, and occipital clusters significantly increased after the presence of mental fatigue. Furthermore, the phase synchronization between the central cluster and the frontal and occipital lobes was significantly weakened. To summarize, the theta bands of frontal, central, and parieto-occipital clusters may serve as powerful biomarkers for monitoring mental fatigue during motor imagery. Additionally, changes in functional connectivity between the central cluster and the prefrontal and occipital lobes during motor imagery could be investigated as potential biomarkers.

The Influence of Changes in Daily Life Habits and Well-Being on Fatigue Level During COVID-19 Pandemic

The COVID-19 pandemic and its lockdown in March 2020 have led to changes in lifestyle and increased levels of anxiety, depression, and fatigue. This survey examined a number of factors (anxiety state, sleep quality, daily activities, mental load, work-related variables) influencing mental and physical fatigue during lockdown and how these relations have evolved one year later. A cohort of 430 workers and 124 retirees were recruited in April-May 2020 (lockdown period, data set 1), and a subsample (133 workers and 40 retirees) completed the same questionnaire in April-May 2021 (data set 2). Linear regression models showed a significant subjective increase in both physical and mental fatigue in both worker and retiree groups during lockdown, and a supplementary increase in physical fatigue and anxiety level in spring 2021 compared to the lockdown period. During lockdown, anxiety level, concerns about COVID-19, work flexibility, mental load, and sleep metrics were associated with the evolution of fatigue among workers. For retirees, only anxiety and physical activity levels were linked to changes in physical fatigue. In April-May 2021, the only associations which remained significant were those in workers between fatigue and anxiety level and workload. These findings suggest that the increased fatigue levels during the lockdown are likely due to the swift and significant changes in daily routines (such as sleep patterns and work dynamics) and psychological states (including increased anxiety and concerns) prompted by the sanitary crisis. On the other hand, the increase in fatigue observed one year after the beginning of the pandemic seems to result from more psychological factors associated with the health situation.

Transcranial Doppler Ultrasound and Concussion-Supplemental Symptoms with Physiology: A Systematic Review

Sport-related concussion (SRC) can impair the cerebrovasculature both acutely and chronically. Transcranial Doppler (TCD) ultrasound assessment has the potential to illuminate the mechanisms of impairment and provide an objective evaluation of SRC. The current systematic review investigated studies employing TCD ultrasound assessment of intracranial arteries across three broad categories of cerebrovascular regulation: neurovascular coupling (NVC), cerebrovascular reactivity (CVR), and dynamic cerebral autoregulation (dCA). The current review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021275627). The search strategy was applied to PubMed, as this database indexes all biomedical journals. Original articles on TCD for athletes with medically diagnosed SRC were included. Title/abstract and full-text screening were completed by three authors. Two authors completed data extraction and risk of bias using the Methodological Index for Non-Randomized Studies and Scottish Intercollegiate Guideline Network checklists. Of the 141 articles identified, 14 met the eligibility criteria. One article used an NVC challenge, eight assessed CVR, and six investigated dCA. Methodologies varied widely among studies, and results were heterogeneous. There was evidence of cerebrovascular impairment in all three domains roughly 2 days post-SRC, but the magnitude and recovery of these impairments were not clear. There was evidence that clinical symptom resolution occurred before cerebrovascular function, indicating that physiological deficits may persist despite clinical recovery and return to play. Collectively, this emphasizes an opportunity for the use of TCD to illuminate the cerebrovascular deficits caused by SRC. It also highlights that there is need for consistent methodological rigor when employing TCD in a SRC population.

Athletes with meditation experience counteract the detrimental effect of mental fatigue on endurance performance and neurocognitive functions

The current study examined whether meditation experience is associated with changes in endurance performance and inhibitory control-relevant neurocognitive functions caused by mental fatigue. Twenty-four athletes with meditation experience (AME) and twenty-five athletes without meditation experience (AWME) underwent a 30-min incongruent Stroop test in mental fatigue condition (MF) and a 30-min congruent Stroop test in control condition (CON) in a randomised-counterbalanced order. Inhibitory control-relevant neurocognitive functions were assessed using Flanker task and event-related potentials, followed by an endurance task using the Bruce treadmill protocol. Visual analogue scale was used to evaluate perceived mental fatigue (VAS-MF) before (T1), after Stroop test (T2) and after Flanker task (T3), and VAS for motivation (VAS-M) was used to evaluate motivation in Flanker task and endurance task. Results indicated that, compared to the CON, AWME in the MF exhibited overall lower accuracy, smaller incongruent N2 amplitude of the Flanker task (ps < .05), and shorter time to exhaustion (TTE) of the endurance task (p < .001), whereas AME did not exhibited difference in these outcomes between the conditions. Along with athletes in the MF reported lower VAS-M in endurance task. These findings suggest the benefits of meditation experience in mitigating the negative effects of mental fatigue.

Does the Effect of Mental Fatigue Created by Motor Imagery on Upper Extremity Functions Change with Diaphragmatic Breathing Exercises? A Randomized, Controlled, Single-Blinded Trial

Background and Objectives: This study focused on the impact of mental fatigue induced by motor imagery on upper limb function, an area with limited research compared to lower limb performance. It aimed to explore how diaphragmatic breathing exercises influence these effects. Materials and Methods: This study included 30 participants, and Group 1 participated in 12 sessions of diaphragmatic breathing exercises under the supervision of a physiotherapist; Group 2 did not receive any intervention. For all the participants, mental fatigue was induced with motor imagery before and after the intervention, and evaluations were performed before and after mental fatigue. Upper extremity functions were evaluated using isometric elbow flexion strength, hand grip strength, upper extremity reaction time and endurance, finger reaction time, the nine-hole peg test, shoulder position sense, light touch-pressure threshold, and two-point discrimination. Results: The study results showed that after mental fatigue, there was a decrease in isometric elbow flexion strength, nondominant hand grip strength, and nondominant upper extremity endurance, and an increase in nondominant tactile sensation (p < 0.05). No changes were found in two-point discrimination, nine-hole peg test time, and position sense on either side (p > 0.05). The effect of mental fatigue on isometric elbow flexion strength and nondominant grip strength showed significant improvement following diaphragmatic breathing exercises (p < 0.05). Conclusions: This study found that mental fatigue from motor imagery can impact elbow flexion, hand grip strength, upper extremity endurance, and tactile sensitivity. Breathing exercises may help improve strength parameters affected by mental fatigue. It is crucial to consider these effects on upper extremity functions in rehabilitation programs.

Contextualising flexible nonlinear periodization as a person-adaptive behavioral model for exercise maintenance

There is a growing focus on developing person-adaptive strategies to support sustained exercise behaviour, necessitating conceptual models to guide future research and applications. This paper introduces Flexible nonlinear periodisation (FNLP) - a proposed, but underdeveloped person-adaptive model originating in sport-specific conditioning - that, pending empirical refinement and evaluation, may be applied in health promotion and disease prevention settings. To initiate such efforts, the procedures of FNLP (i.e., acutely and dynamically matching exercise demand to individual assessments of mental and physical readiness) are integrated with contemporary health behaviour evidence and theory to propose a modified FNLP model and to show hypothesised pathways by which FNLP may support exercise adherence (e.g., flexible goal setting, management of affective responses, and provision of autonomy/variety-support). Considerations for future research are also provided to guide iterative, evidence-based efforts for further development, acceptability, implementation, and evaluation.

Absence of Monotony and Strain Effects on Referees' Physical Performance During International Basketball Federation World Cup Basketball Competition

PURPOSE

The study aimed to conduct a comparative analysis of physical performance indicators and assess the levels of performance monotony and strain experienced by basketball referees.

METHODS

The study involved the participation of 12 basketball referees (mean age: 40.0 [4.9] y) affiliated with the International Basketball Federation. The investigation was carried out throughout 2 density tournaments, wherein the maximum heart rate, average heart rate, performance monotony, and performance strain were documented for 3 variables.

RESULTS

The findings indicated significant variations in the mean heart rate, maximum heart rate, total distance monotony, total distance strain, the total number of sprints monotony, the total number of sprints strain, calories monotony, and calories strain (P < .05). Decreasing the density of elite-level basketball competitions has been observed to reduce the monotony and strain experienced by referees. However, this action does not increase motion distance or speed zones.

CONCLUSIONS

The environmental stressors experienced by senior-level athletes (World Cup) differ from those encountered by younger athletes (World Cup Under 19). Further investigation is required to ascertain the potential effects of competition monotony and strain on decision-making processes and the overall quality of refereeing.

Creatine supplementation research fails to support the theoretical basis for an effect on cognition: Evidence from a systematic review

Creatine supplementation has been put forward as a possible aid to cognition, particularly for vegans, vegetarians, the elderly, sleep deprived and hypoxic individuals. However, previous narrative reviews have only provided limited support for these claims. This is despite the fact that research has shown that creatine supplementation can induce increased brain concentrations of creatine, albeit to a limited extent. We carried out a systematic review to examine the current state of affairs. The review supported claims that creatine supplementation can increases brain creatine content but also demonstrated somewhat equivocal results for effects on cognition. It does, however, provide evidence to suggest that more research is required with stressed populations, as supplementation does appear to significantly affect brain content. Issues with research design, especially supplementation regimens, need to be addressed. Future research must include measurements of creatine brain content.

Sleep deprivation increases the regularity of isometric torque fluctuations

The regularity of the fluctuations present in torque signals represent the adaptability of the motor control. While previous research showed how it is affected by neuromuscular fatigue and ageing, the underlying mechanisms remain unclear. It is currently under debate whether these changes are explained by central or peripheral neuromuscular mechanisms. Here, we experimentally manipulated the sleep of thirteen young adults through a supervised 24 h-sleep deprivation protocol. This study aimed to investigate the effect of sleep deprivation on the regularity of torque fluctuations, and other standard torque-related outcomes (Peak Torque - PT - and Rate of Torque Development - RTD). The participants were asked to perform knee extension maximal voluntary contractions (MVC) and submaximal knee extensions at 40% of MVC for 30 s. PT and RTD were calculated from the MVC and the regularity of the torque fluctuations was determined on the submaximal task through Sample Entropy (SampEn). In addition, rate of perceived effort (RPE) was collected. We found no significant changes in PT and RTD. The regularity of torque fluctuations significantly increased (i.e., a decrease in SampEn) after 24 h-sleep deprivation (PRE = 1.76 ± 0.268, POS24 = 1.71 ± 0.306; p = 0.044). Importantly, we found a negative correlation between RPE and SampEn relative changes after sleep deprivation. This study brings new insights towards the understanding of the underlying mechanisms that explain changes in torque fluctuations, demonstrating that these changes are not limited to neuromuscular processes but are also likely to be affected by other domains, such as psychological profile, which can indirectly affect the neural drive to the muscles.

Effect of mental fatigue on mean propulsive velocity, countermovement jump, and 100-m and 200-m dash performance in male college sprinters

The objective of this study was to analyze the effect of mental fatigue on mean propulsive velocity (MPV), countermovement jump (CMJ), 100, and 200-m dash performance in college sprinters. A total of 16 male athletes of sprint events (100 and 200-m dash) participated in this study. Each participant underwent two baseline visits and then running under the three experimental conditions. Assessments (MPV and CMJ) occurred both before and after either smartphone use (SMA) or Stroop task (ST), or watching a documentary TV show about the Olympic Games (CON). Then, the athletes ran the simulated race (i.e. the 100 and 200-m dash). There was no condition (p > 0.05) or time effect (p > 0.05) for MPV, CMJ, 100-m, or 200-m dash performance. In conclusion, the present study results revealed no mental fatigue effect induced by SMA or ST on neuromuscular, 100-m or 200-m dash performance in male college sprinters.

The Impact of Mental Fatigue on a Strength Endurance Task: Is There a Role for the Movement-Related Cortical Potential?

PURPOSE

Several mechanisms have been proposed to explain how mental fatigue degrades sport performance. In terms of endurance performance, a role for an increased perceived exertion has been demonstrated. Using electroencephalography and, more specifically, the movement-related cortical potential (MRCP), the present study explored the neural mechanisms that could underlie the mental fatigue-associated increase in perceived exertion.

METHODS

Fourteen participants (age, 23 ± 2 yr; 5 women, 9 men) performed one familiarization and two experimental trials in a randomized, blinded, crossover study design. Participants had to complete a submaximal leg extension task after a mentally fatiguing task (EXP; individualized 60-min Stroop task) or control task (CON; documentary). The leg extension task consisted of performing 100 extensions at 35% of 1 repetition maximum, during which multiple physiological (heart rate, electroencephalography) and subjective measures (self-reported feeling of mental fatigue, cognitive load, behand motivation, ratings of perceived exertion) were assessed.

RESULTS

Self-reported feeling of mental fatigue was higher in EXP (72 ± 18) compared with CON (37 ± 17; P < 0.001). A significant decrease in flanker accuracy was detected only in EXP (from 0.96 ± 0.03% to 0.03%; P < 0.05). No significant differences between conditions were found in MRCP characteristics and perceived exertion. Specifically in EXP, alpha wave power increased during the leg extension task ( P < 0.01).

CONCLUSIONS

Mental fatigue did not impact the perceived exertion or MRCP characteristics during the leg extension task. This could be related to low perceived exertion and/or the absence of a performance outcome during the leg extension task. The increase in alpha power during the leg extension task in EXP suggests that participants may engage a focused internal attention mechanism to maintain performance and mitigate feelings of fatigue.

Counteracting mental fatigue for athletes: a systematic review of the interventions

The deleterious effects of mental fatigue (MF) on athletes have been carefully studied in various sports, such as soccer, badminton, and swimming. Even though many researchers have sought ways to ameliorate the negative impact of MF, there is still a lack of studies that review the interventions used to counteract MF among athletes. This review aims to report the current evidence exploring the effects of interventions on MF and sport-specific performance, including sport-specific motor performance and perceptual-cognitive skills. Web of Science, Scopus, PubMed, and SPORTDicus (EBSCOhost) were combed through to find relevant publications. Additionally, the references and Google Scholar were searched for any grey literature. For the current review, we included only randomized controlled trials that involved athletes, a primary task to induce MF, interventions to counter MF with comparable protocols, and the outcomes of sport-specific motor performance and perceptual-cognitive skill. The selection criteria resulted in the inclusion of 10 articles. The manipulations of autonomous self-control exertion, person-fit, nature exposure, mindfulness, and transactional direct current stimulation showed that positive interventions counteract MF and improve sport-specific performance in different domains, including strength, speed, skill, stamina, and perceptual-cognitive skills. The selected interventions could significantly counteract MF and improve subsequent sport-specific performance. Moreover, self-regulation and attention resources showed the importance of the potential mechanisms behind the relevant interventions.

The influence of the perceived requirements of the next match and motivation on the mental fatigue of soccer players

The high cognitive and/or emotional demands of competition can lead to a state of mental fatigue which has shown to be detrimental to soccer performance. However, there is a need to further understand the true mental demands of soccer players. The aim of the present study was to analyze the influence of motivation and the perceived requirements of the next match on mental fatigue perceived by soccer players over the passing of a season. The combined effect of both variables on the perception of mental fatigue, as well as the influence of the time of the season on perceived mental fatigue, were also analyzed. Twenty-six semi-professional Spanish male players (M = 26.31 ± 5.18 years) participated in the present study, conducted during the 2020-2021 season. Perceived mental fatigue and motivation were measured at each training session. The perceived requirements of the next match were also measured in each of the competitive weeks. Linear mixed models were run with R Studio to examine the influence of motivation and the perceived difficulty of the next match on perceived mental fatigue, the combined effect of both variables on perceived mental fatigue, and the influence of the passing of the season on perceived mental fatigue. The results showed a negative and significant influence of motivation on perceived mental fatigue (p < 0.001) and a positive and significant influence of the perceived requirements of the next match on perceived mental fatigue (p < 0.001). Regarding the combined effect, there was a positive and significant effect (p < 0.01) of the perceived difficulty of the next match on the relation between motivation and perceived mental fatigue. A negative influence of season passage on perceived mental fatigue levels was found (p < 0.001). We recommended coaches to consider using the most motivating training tasks when higher next-match requirements are perceived and to be careful with avoidance strategies for mental fatigue, especially at the beginning of the season.

Relationship between Volitional and Non-Volitional Quadriceps Muscle Endurance in Patients with Chronic Obstructive Pulmonary Disease

Volitional assessment of quadriceps muscle endurance is clinically relevant in patients with chronic obstructive pulmonary disease (COPD). However, studies that determine the construct validity of volitional tests by comparing them to non-volitional measures are lacking. Therefore, the aim of the current study is to evaluate the correlation between volitional and non-volitional quadriceps muscle endurance in patients with COPD. Quadriceps muscle endurance was evaluated in twenty-six patients with COPD. A volitional isometric and a volitional isokinetic protocol were performed on a computerised dynamometer to determine the isometric time and isokinetic work fatigue index, respectively. Non-volitional assessment of quadriceps muscle endurance was evaluated using repetitive electrical stimulations to establish the isometric muscle force decline. Sixteen patients (61 ± 8 years, 63% male, FEV1 47 (32-53)%) performed all three quadriceps endurance tests conforming to pre-defined test criteria. Both volitional isometric time and isokinetic work fatigue index did not significantly correlate with non-volitional muscle force decline (both p > 0.05). There was a strong correlation between volitional isometric time and isokinetic work fatigue index (rho = -0.716, p = 0.002). To conclude, this study suggests that volitional measures evaluate partly different aspects of quadriceps muscle endurance compared to non-volitional measures. Accordingly, these outcome measures cannot be used interchangeably.

Effects of smartphone use before resistance exercise on inhibitory control, heart rate variability, and countermovement jump

BACKGROUND

The effect of MF induced by exposure time to social media smartphone apps on inhibitory control, heart rate variability (HRV), and high-intensity physical effort following a resistance exercise session might indicate whether strength and conditioning professionals should suggest avoiding smartphone usage before a resistance exercise session.

AIM

The objective of this study was to analyze the effect of mental fatigue on inhibitory control, HRV, and countermovement jump (CMJ) in trained adults after resistance exercise.

METHODS

A total of 16 trained males (21.4 ± 3.3 years) volunteered in this study. The participants performed resistance exercises with and without mental fatigue. The Stroop Task, countermovement jump, and heart rate variability were evaluated before and after the resistance exercise. The participants used smartphones in the mental fatigue condition, whereas the participants watched TV in the control condition.

RESULTS

No condition × time interaction was found for the Stroop accuracy (p = 0.87), CMJ (p = 0.68), SDNN (p = 0.15), or pNN50 (p = 0.15) in the heart rate variability. An interaction was found for Stroop response time (p = 0.01) with a higher response time for the mental fatigue condition (p = 0.01).

CONCLUSIONS

Mental fatigue impaired the inhibitory control performance after a resistance exercise session in trained adults.

"A sprained ankle is the biggest sign of mental fatigue": A qualitative study of the perceptions and experiences of mental fatigue in professional ballet

Mental fatigue is known to influence endurance, skill, and tactical performance in sport. Research investigating the impact of mental fatigue on tasks that combine physical, cognitive, and aesthetic performance such as professional ballet does not exist.

OBJECTIVE

To understand the perceptions and experiences of mental fatigue in professional ballet.

DESIGN

Qualitative, focus groups and semi-structured interviews.

SETTING

The Australian Ballet.

PARTICIPANTS

Thirty-nine professional ballet dancers (53% of the company) and six dance staff members aged 18 years or above (53% female).

MAIN OUTCOME MEASURES

N/a.

RESULTS

The average focus group and interview length was 48 ± 7 min and 41 ± 8 min. Key categories were; (1) Dancers and dance staff perceive that new learning contributes to mental fatigue, (2) Dancers perceive changes to their mood and perception of effort when they are mentally fatigued, and (3) Dancers and dance staff perceive that mental fatigue negatively affects their physical and cognitive performance and, increases their risk of injury.

CONCLUSION

This is the first study where participants associated mental fatigue with injury risk and provides a springboard to measure the impact of mental fatigue on learning, injury, and performance in professional ballet.

Global practitioner assessment and management of mental fatigue and mental recovery in high-performance sport: A need for evidence-based best-practice guidelines

BACKGROUND

Mental fatigue and mental recovery have gained scientific attention in relation to sporting performance, yet best practice assessment and management methods are lacking. A greater understanding of current knowledge and practices in high-performance sport are necessary.

OBJECTIVE

To understand the contemporary knowledge, beliefs, monitoring processes, management strategies, perceived responsibility, sources of evidence, and challenges, when assessing the mental fatigue and mental recovery of athletes in high-performance sport.

METHODS

A mixed-methods survey approach obtained information from 156 multi-disciplinary high-performance sport practitioners. Descriptive outputs were reported and potential differences between key concepts were detected using Wilcoxon-signed rank analysis. Thematic analysis interpreted open-text responses.

RESULTS

Only 11.5% and 5.1% of respondents indicated they were "very" knowledgeable about mental fatigue and mental recovery, respectively. Knowledge (p < 0.001) and confidence in application (p = 0.001) were significantly greater for mental fatigue than mental recovery. Nearly all respondents perceived mental fatigue and mental recovery impacted training and competition performance, with a greater negative impact during competition (p < 0.001). A limited number of respondents reported deliberate assessment (31.1%) or management (51.2%) of mental fatigue and mental recovery. A combination of sources of evidence were used to inform practice, with common challenges to implementation including staff knowledge, athlete-buy in, time-availability, and a lack of evidence. Practitioners reported that assessing and managing mental fatigue and mental recovery was multi-disciplinary in nature.

CONCLUSION

Practitioners reported that mental fatigue and mental recovery did impact performance, yet this was not reflected in the implementation of evidence-based assessment and management practices in high-performance sport.

More than energy cost: multiple benefits of the long Achilles tendon in human walking and running

Elastic strain energy that is stored and released from long, distal tendons such as the Achilles during locomotion allows for muscle power amplification as well as for reduction of the locomotor energy cost: as distal tendons perform mechanical work during recoil, plantar flexor muscle fibres can work over smaller length ranges, at slower shortening speeds, and at lower activation levels. Scant evidence exists that long distal tendons evolved in humans (or were retained from our more distant Hominoidea ancestors) primarily to allow high muscle-tendon power outputs, and indeed we remain relatively powerless compared to many other species. Instead, the majority of evidence suggests that such tendons evolved to reduce total locomotor energy cost. However, numerous additional, often unrecognised, advantages of long tendons may speculatively be of greater evolutionary advantage, including the reduced limb inertia afforded by shorter and lighter muscles (reducing proximal muscle force requirement), reduced energy dissipation during the foot-ground collisions, capacity to store and reuse the muscle work done to dampen the vibrations triggered by foot-ground collisions, reduced muscle heat production (and thus core temperature), and attenuation of work-induced muscle damage. Cumulatively, these effects should reduce both neuromotor fatigue and sense of locomotor effort, allowing humans to choose to move at faster speeds for longer. As these benefits are greater at faster locomotor speeds, they are consistent with the hypothesis that running gaits used by our ancestors may have exerted substantial evolutionary pressure on Achilles tendon length. The long Achilles tendon may therefore be a singular adaptation that provided numerous physiological, biomechanical, and psychological benefits and thus influenced behaviour across multiple tasks, both including and additional to locomotion. While energy cost may be a variable of interest in locomotor studies, future research should consider the broader range of factors influencing our movement capacity, including our decision to move over given distances at specific speeds, in order to understand more fully the effects of Achilles tendon function as well as changes in this function in response to physical activity, inactivity, disuse and disease, on movement performance.

Effect of brain endurance training on maximal oxygen uptake, time-to-exhaustion, and inhibitory control in runners

We aimed to analyze the effect of brain endurance training on maximum oxygen consumption (VO2máx ), time-to-exhaustion, and inhibitory control in amateur trained runners. We employed a mixed experimental design, with the group as the between-participant factor and time as the within-participant factor. 45 participants attended 36 training sessions over 12 weeks. The cognitive training group (CT) performed the Stroop word-color task [trials of each type (congruent, incongruent, and neutral) were randomly presented during each training session], the endurance training group (ET) participated in a running training program (intensity was 60%Δ of maximal aerobic velocity and performed on a motor-driven treadmill), and the brain endurance training group (BET) make cognitive and endurance training simultaneously over 12 weeks. The total time of each session (i.e., 20-40 min) was identical in the experimental groups. VO2máx , time-to-exhaustion, and inhibitory control tests were measured before (baseline) and after (post-experiment) the 12-week intervention. A significant effect of interaction (group × time) for VO2máx (p < 0.05) was found. A post-hoc test showed an increase in VO2máx from baseline to post-experiment only for ET (Δ% = 2.98) and BET (Δ% = 3.78) groups (p < 0.05). Also, the analyses showed a significant interaction (group × time) for time-to-exhaustion (p < 0.05), and a post-hoc test revealed an improvement in time-to-exhaustion for ET (Δ% = 8.81) and BET (Δ% = 11.01) (p < 0.05). No group × time interaction was found for accuracy and response time in the inhibitory control task (p > 0.05). The results conclude that BET was not superior to ET for improving VO2máx and time-to-exhaustion. Also, the findings conclude that BET improved inhibitory control similar to CT.

Post-COVID-19 syndrome: Physical capacity, fatigue and quality of life

PURPOSE

Post-Covid-19 syndrome is defined as the persistence of symptoms beyond 3 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The most common symptoms include reduced exercise tolerance and capacity, fatigue, neurocognitive problems, muscle pain and dyspnea. The aim of our work was to investigate exercise capacity and markers of subjective wellbeing and their independent relation to post-COVID-19 syndrome.

PATIENTS AND METHODS

We examined a total of 69 patients with post-COVID-19 syndrome (23 male/46 female; age 46±12 years; BMI 28.9±6.6 kg/m2) with fatigue and a score ≥22 in the Fatigue Assessment Scale (FAS). We assessed exercise capacity on a cycle ergometer, a 6-minute walk test, the extent of fatigue (FAS), markers of health-related quality of life (SF-36 questionnaire) and mental health (HADS).

RESULTS

On average the Fatigue Assessment Scale was 35.0±7.4 points. Compared with normative values the VO2max/kg was reduced by 8.6±5.8 ml/min/kg (27.7%), the 6MWT by 71±96 m (11.9%), the health-related quality of life physical component score by 15.0±9.0 points (29.9%) and the mental component score by 10.6±12.8 points (20.6%). Subdivided into mild fatigue (FAS score 22-34) and severe fatigue (FAS score ≥35), patients with severe fatigue showed a significant reduction of the 6-minute walk test by 64±165 m (p<0.01) and the health-related quality of life physical component score by 5.8±17.2 points (p = 0.01). In multiple regression analysis age (β = -0.24, p = 0.02), sex (β = 0.22, p = 0.03), mental (β = -0.51, p<0.01) and physical (β = -0.44, p<0.01) health-related quality of life and by trend the 6-minute walk test (β = -0.22, p = 0.07) were associated with the FAS.

CONCLUSION

Patients with post-COVID-19 syndrome show reduced maximal and submaximal physical performance as well as limitations in quality of life, particularly pronounced in the physical components. These results are essentially influenced by the severity of fatigue and implicating the need for targeted treatments.

Head-to-head opponent mitigates mental fatigue effects during a 20-km time trial in well-trained cyclists

We aimed to analyze the effect of a head-to-head virtual race on 20-km time trial performance in well-trained mentally fatigued cyclists. A total of 24 male professional cyclists participated in the present study, which was conducted in a within-factors design [four experimental conditions × four times (throughout 20-km time trial cycling)]. An avatar representing the participant on the racecourse was visible during the time trials. Then, a second virtual avatar representing the opponent was projected onto the screen in the mental fatigue head-to-head and control head-to-head experimental conditions. Measurements [rating of perceived exertion, heart rate, and eye-tracking measures (i.e., pupil diameter)] were performed every 5-km throughout the 20-km time trial. As a result, impaired total time, power output, and cadence throughout the 20-km cycling time trial were found for mental fatigue compared to mental fatigue head-to-head, control head-to-head, and control conditions (p < 0.05). Also, impaired 20-km time trial performance (total time, power output, and cadence) was found for mental fatigue head-to-head compared to control head-to-head (p < 0.05). Moreover, lower RPE was found for the control and control head-to-head conditions than mental fatigue head-to-head and mental fatigue experimental conditions (p < 0.05). Higher pupil diameter was also found for mental fatigue head-to-head, control head-to-head, and control than the mental fatigue experimental condition (p < 0.05). In summary, the overall performance throughout the 20-km cycling time trial was improved by the presence of a virtual opponent for the mentally fatigued cyclists.

Transforming fatigue assessment: Smartphone-based system with digitized motor skill tests

BACKGROUND

The condition of fatigue is a complex and multifaceted disorder that encompasses physical, mental, and psychological dimensions, all of which contribute to a decreased quality of life. Smartphone-based systems are gaining significant research interest due to their potential to provide noninvasive monitoring and diagnosis of diseases.

OBJECTIVE

This paper studies the feasibility of using smartphones to collect motor skill related data for machine learning based fatigue detection. The authors' main goal is to provide valuable insights into the nature of fatigue and support the development of more effective interventions to manage it.

METHODS

An application for smartphones running on Android OS is developed. Two aim-based reaction tests, an Archimedean spiral test, and a tremor test, were assembled. 41 subjects participated in the study. The resulting dataset consists of 131 trials of fatigue assessment alongside digital signals extracted from the motor skill tests. Six machine learning classifiers were trained on computed features extracted from the collected digital signals.

RESULTS

The collected dataset SmartPhoneFatigue is presented for further research. The real-world utility of this database was shown by creating a methodology to construct a fatigue predictive model. Our approach incorporated 60 distinct features, such as kinematic, angular, aim-based, and tremor-related measures. The machine learning models exhibited a high degree of prediction rate for fatigue state, with an accuracy exceeding 70%, sensitivity surpassing 90%, and an f1-score greater than 80%.

CONCLUSION

The results demonstrate that the proposed smartphone-based system is suitable for motion data acquisition in non-controlled environments and shows promise as a more objective and convenient method for measuring fatigue.

The impact of sprint, middle-distance, and long-distance orienteering races on perceived mental fatigue in national level orienteers

Experiencing mental fatigue (MF) before an orienteering race can lead to a slower completion time. This study aimed to explore the changes in perceived MF, mood and other psychological responses during an orienteering competition. Sixteen national level orienteering athletes (20.8 ± 4.9 years) provided informed consent and completed the online surveys, before and immediately after each race, and 24- and 48-hours post competition (48POST). This study measured MF, physical fatigue, stress, tiredness and motivation using 0-100 Visual Analogue Scale, and the mood was assessed using The Brunel Mood Scale (BRUMS). A moderate to large increase in MF (ES = 0.93 [0.54 to 1.31]), BRUMS fatigue (ES = 0.61 [0.3 to 0.92]), and PF (ES = 1.21 [0.81 to 1.61]) was reported following orienteering races. A small increase in tiredness and BRUMS confusion, and a small decrease in motivation, stress and BRUMS vigour was also reported. There was a delay in recovering from the MF elicited by competition, with a small increase in MF (ES = 0.54 [0.08 to 1.15]) at 48POST compared to the pre-competition value. This study found that orienteers experience MF during competition and have a delayed recovery that can last up to two days after the competition.

Mental fatigue impairs physical performance but not the neural drive to the muscle: a preliminary analysis

Mental fatigue (MF) does not only affect cognitive but also physical performance. This study aimed to explore the effects of MF on muscle endurance, rate of perceived exertion (RPE), and motor units' activity. Ten healthy males participated in a randomised crossover study. The subjects attended two identical experimental sessions separated by 3 days with the only difference of a cognitive task (incongruent Stroop task [ST]) and a control condition (watching a documentary). Perceived MF and motivation were measured for each session at baseline and after each cognitive task. Four contractions at 20% of maximal voluntary contraction (MVIC) were performed at baseline, after each cognitive and after muscle endurance task while measuring motor units by high-density surface electromyography. Muscle endurance until failure at 50% of MVIC was measured after each cognitive task and the RPE was measured right after failure. ST significantly increased MF (p = 0.001) reduced the motivation (p = 0.008) for the subsequent physical task and also impaired physical performance (p = 0.044). However, estimates of common synaptic inputs and motor unit discharge rates as well as RPE were not affected by MF (p > 0.11). In conclusion, MF impairs muscle endurance and motivation for the physical task but not the neural drive to the muscle at any frequency bands. Although it is physiologically possible for mentally fatigued subjects to generate an optimal neuromuscular function, the altered motivation seems to limit physical performance. Preliminarily, our results suggest that the corticospinal pathways are not affected by MF.

Work performance in industry: The impact of mental fatigue and a passive back exoskeleton on work efficiency

Mental fatigue (MF) is likely to occur in the industrial working population. However, the link between MF and industrial work performance has not been investigated, nor how this interacts with a passive lower back exoskeleton used during industrial work. Therefore, to elucidate its potential effect(s), this study investigated the accuracy of work performance and movement duration through a dual task paradigm and compared results between mentally fatigued volunteers and controls, with and without the exoskeleton. No main effects of MF and the exoskeleton were found. However, when mentally fatigued and wearing the exoskeleton, movement duration significantly increased compared to the baseline condition (β_MF:Exo = 0.17, p = .02, ω² = .03), suggesting an important interaction between the exoskeleton and one's psychobiological state. Importantly, presented data indicate a negative effect on production efficiency through increased performance time. Further research into the cognitive aspects of industrial work performance and human-exoskeleton interaction is therefore warranted.

A Quantitative Investigation of Mental Fatigue Elicited during Motor Imagery Practice: Selective Effects on Maximal Force Performance and Imagery Ability

In the present study, we examined the development of mental fatigue during the kinesthetic motor imagery (MI) of isometric force contractions performed with the dominant upper limb. Participants (n = 24) underwent four blocks of 20 MI trials of isometric contractions at 20% of the maximal voluntary contraction threshold (20% MVC_MI) and 20 MI trials of maximal isometric contractions (100% MVC_MI). Mental fatigue was assessed after each block using a visual analogue scale (VAS). We assessed maximal isometric force before, during and after MI sessions. We also assessed MI ability from self-report ratings and skin conductance recordings. Results showed a logarithmic pattern of increase in mental fatigue over the course of MI, which was superior during 100% MVC_MI. Unexpectedly, maximal force improved during 100% MVC_MI between the 1st and 2nd evaluations but remained unchanged during 20% MVC_MI. MI ease and vividness improved during 100% MVC_MI, with a positive association between phasic skin conductance and VAS mental fatigue scores. Conversely, subjective measures revealed decreased MI ability during 20% MVC_MI. Mental fatigue did not hamper the priming effects of MI on maximal force performance, nor MI's ability for tasks involving high physical demands. By contrast, mental fatigue impaired MI vividness and elicited boredom effects in the case of motor tasks with low physical demands.

Monitoring cognitive function in the fatigued warfighter: A rapid review of cognitive biomarkers

OBJECTIVES

Decreases in cognitive function impair occupational performance, reduce occupational safety, and increase musculoskeletal injury risk. The aim of this paper was to identify measures that may be used to monitor cognitive function in the warfighter.

DESIGN

A rapid review.

METHODS

A rapid search of Academic Search Complete, MEDLINE, PsycINFO, and SPORTSDiscus databases was conducted.

ELIGIBILITY CRITERIA

original peer reviewed research articles, written in English, published between 2002 and 2022, and using human participants with no health issues in military training environments or active service.

RESULTS

Of the 248 articles screened, 58 full-text articles were assessed for eligibility and 29 included in the review. Of these, 16 papers presented data from multi-stressor military training environments, or experimental studies where simulated military tasks were being performed. Thirteen papers focused on an aspect of military work and the implications for cognitive function (i.e., physical load, periods of extended wakefulness or fatigue, and hypoxic conditions). The domains of cognitive function that were assessed (i.e. vigilance, reaction time, working memory, situational awareness, and decision-making) were somewhat consistent among studies.

CONCLUSIONS

Prolonged exposure to high-stress military environments compromises multiple aspects of cognitive function. These findings highlight the need for a suite of biomarkers to monitor cognitive function and assess the ability of military personnel to attend to and process mission-critical information and make appropriate decisions on the battlefield and other high-stress environments. Our findings suggest that a suite of common tests may provide useful information about cognitive function in the warfighter.

Playing videogames or using social media applications on smartphones causes mental fatigue and impairs decision-making performance in amateur boxers

This study aimed to analyze the effect of playing videogames and using social media applications on smartphones on decision-making and countermovement jump (CMJ) performance in amateur boxers. Twenty one boxers were enrolled in the study and were randomly assigned to all three experimental conditions [smartphone (30SMA), videogame (30VID), and control (CON)]. CMJ was measured before and 30-min after each experimental condition. The athletes ran simulated combat recorded for decision-making analysis. The boxers watched coaching videos (CON), used social media applications on smartphones (30SMA), and played video games (30VID) for 30 min just before the combat simulation. Both attack and defense decision-making performance were worse in both 30SMA and 30VID conditions compared to the CON condition (p = 0.001). Regarding CMJ, despite no condition effect (p = 0.96) been obtained, a time effect (p = 0.001) was observed; So, it was found a decrease in CMJ performance after all experimental conditions (p = 0.001), with no difference between them. Using social media applications on smartphones and playing video game impairs decision-making performance in amateur boxers, with no harms for CMJ performance.

Interindividual Variability in Mental Fatigue-Related Impairments in Endurance Performance: A Systematic Review and Multiple Meta-regression

BACKGROUND

The negative effect of mental fatigue (MF) on physical performance has recently been questioned. One reason behind this could lie in the interindividual differences in MF-susceptibility and the individual features influencing them. However, the range of individual differences in mental fatigue-susceptibility is not known, and there is no clear consensus on which individual features could be responsible for these differences.

OBJECTIVE

To give an overview of interindividual differences in the effects of MF on whole-body endurance performance, and individual features influencing this effect.

METHODS

The review was registered on the PROSPERO database (CRD42022293242). PubMed, Web of Science, SPORTDiscus and PsycINFO were searched until the 16th of June 2022 for studies detailing the effect of MF on dynamic maximal whole-body endurance performance. Studies needed to include healthy participants, describe at least one individual feature in participant characteristics, and apply at least one manipulation check. The Cochrane crossover risk of bias tool was used to assess risk of bias. The meta-analysis and regression were conducted in R.

RESULTS

Twenty-eight studies were included, with 23 added to the meta-analysis. Overall risk of bias of the included studies was high, with only three presenting an unclear or low rating. The meta-analysis shows the effect of MF on endurance performance was on average slightly negative (g = - 0.32, [95% CI - 0.46; - 0.18], p < 0.001). The multiple meta-regression showed no significant influences of the included features (i.e. age, sex, body mass index and physical fitness level) on MF-susceptibility.

CONCLUSIONS

The present review confirmed the negative impact of MF on endurance performance. However, no individual features influencing MF-susceptibility were identified. This can partially be explained by the multiple methodological limitations such as underreporting of participant characteristics, lack of standardization across studies, and the restricted inclusion of potentially relevant variables. Future research should include a rigorous description of multiple different individual features (e.g., performance level, diet, etc.) to further elucidate MF mechanisms.

Endogenous and Exogenous Antioxidants in Skeletal Muscle Fatigue Development during Exercise

Muscle fatigue is defined as a decrease in maximal force or power generated in response to contractile activity, and it is a risk factor for the development of musculoskeletal injuries. One of the many stressors imposed on skeletal muscle through exercise is the increased production of reactive oxygen species (ROS) and reactive nitrogen species (RNS), which intensifies as a function of exercise intensity and duration. Exposure to ROS/RNS can affect Na⁺/K⁺-ATPase activity, intramyofibrillar calcium turnover and sensitivity, and actin-myosin kinetics to reduce muscle force production. On the other hand, low ROS/RNS concentrations can likely upregulate an array of cellular adaptative responses related to mitochondrial biogenesis, glucose transport and muscle hypertrophy. Consequently, growing evidence suggests that exogenous antioxidant supplementation might hamper exercise-engendering upregulation in the signaling pathways of mitogen-activated protein kinases (MAPKs), peroxisome-proliferator activated co-activator 1α (PGC-1α), or mammalian target of rapamycin (mTOR). Ultimately, both high (exercise-induced) and low (antioxidant intervention) ROS concentrations can trigger beneficial responses as long as they do not override the threshold range for redox balance. The mechanisms underlying the two faces of ROS/RNS in exercise, as well as the role of antioxidants in muscle fatigue, are presented in detail in this review.

International orienteering experts' consensus on the definition, development, cause, impact and methods to reduce mental fatigue in orienteering: A Delphi study

Orienteering is an outdoor activity wherein participants use a map and compass to locate control points and choose the quickest path to the next control point in a natural environment. Attentional focus, rapid decision-making, and high aerobic fitness may influence orienteering performance. Therefore, this research aimed to seek international orienteering expert consensus regarding the definition, development, causes, influences and methods to reduce mental fatigue (MF) in orienteering based on practical experience. Following ethical approval, a three-round Delphi survey was conducted online with twenty-four orienteering coaches and athletes (or former athletes) from 10 different countries with international orienteering competition experience. The threshold of consensus was ≥ 70% agreement among respondents. The experts agreed that MF exists in daily life and orienteering with a substantial negative effect on their conscious decision-making performance and psychological responses. The experts disagreed that the form of MF that athletes experienced in orienteering training are similar to the competition. However, there was no agreement that MF would impact endurance and high-speed running performance during orienteering. This research refines the definition of MF and summarises the distinctions in what causes MF in orienteering training and competition, implying that MF should be addressed separately.

Probing the Promises of Noninvasive Transcranial Electrical Stimulation for Boosting Mental Performance in Sports

While the importance of physical abilities is noncontested to perform in elite sport, more focus has recently been turned toward cognitive processes involved in sport performance. Practicing any sport requires a high demand of cognitive functioning including, but not limited to, decision-making, processing speed, working memory, perceptual processing, motor functioning, and attention. Noninvasive transcranial electrical stimulation (tES) has recently attracted considerable scientific interest due to its ability to modulate brain functioning. Neuromodulation apparently improves cognitive functions engaged in sports performance. This opinion manuscript aimed to reveal that tES is likely an adjunct ergogenic resource for improving cognitive processes, counteracting mental fatigue, and managing anxiety in elite athletes. Nevertheless, the first evidence is insufficient to guarantee its real effectiveness and benefits. All tES techniques could be add-ons to make performance-related cognitive functions more efficient and obtain better results. Modulating inhibitory control through tES over the frontal cortex might largely contribute to the improvement of mental performance. Nevertheless, studies in elite athletes are required to assess the long-term effects of tES application as an ergogenic aid in conjunction with other training methods (e.g., neurofeedback, mental imagery) where cognitive abilities are trainable.

Effects of molecular hydrogen supplementation on fatigue and aerobic capacity in healthy adults: A systematic review and meta-analysis

Background

Fatigue is oftentimes induced by high-intensity exercise potentially via the exceeded amount of reactive oxygen species, leading to diminished functions (e.g., aerobic capacity) and increased risk of injuries. Studies indicate that molecular hydrogen (H₂), with antioxidant and anti-inflammatory properties, may be a promising strategy to alleviate fatigue and improve aerobic capacity. However, such effects have not been comprehensively characterized.

Objective

To systematically assess the effects of in taking H₂ on fatigue and aerobic capacity in healthy adults.

Methods

The search was conducted in August 2022 in five databases. Studies with randomized controlled or crossover designs that investigated the rating of perceived exertion (RPE), maximal oxygen uptake (VO_2max), peak oxygen uptake (VO_2peak), and endurance performance were selected. The data (mean ± standard deviation and sample size) were extracted from the included studies and were converted into the standardized mean difference (SMD). Random-effects meta-analyses were performed. Subgroup analysis was used to analyze potential sources of heterogeneity due to intervention period, training status, and type of exercise.

Results

Seventeen publications (19 studies) consisting of 402 participants were included. The pooled effect sizes of H₂ on RPE (SMD_pooled = -0.38, 95%CI -0.65 to -0.11, p = 0.006, I ² = 33.6%, p = 0.149) and blood lactate (SMD_pooled = -0.42, 95% CI -0.72 to -0.12, p = 0.006, I ² = 35.6%, p = 0.114) were small yet significant with low heterogeneity. The pooled effect sizes of H₂ on VO_2max and VO_2peak (SMD_pooled = 0.09, 95% CI -0.10 to 0.29, p = 0.333, I ² = 0%, p = 0.998) and endurance performance (SMD_pooled = 0.01, 95% CI -0.23 to 0.25, p = 0.946, I ² = 0%, p > 0.999) were not significant and trivial without heterogeneity. Subgroup analysis revealed that the effects of H₂ on fatigue were impacted significantly by the training status (i.e., untrained and trained), period of H₂ implementation, and exercise types (i.e., continuous and intermittent exercises).

Conclusions

This meta-analysis provides moderate evidence that H₂ supplementation alleviates fatigue but does not enhance aerobic capacity in healthy adults.

Systematic review registration

www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022351559.